a Department of Occupational Science and Technology , University of Wisconsin-Milwaukee , Milwaukee , WI , USA.
b Department of Physical Therapy , Northeastern University , Boston , MA , USA.
Physiother Theory Pract. 2019 Sep;35(9):851-859. doi: 10.1080/09593985.2018.1458930. Epub 2018 Apr 2.
: Global rating of change (GROC) scores provide a means of measuring patients' self-perceived change in health status over time. : The purposes of the study were to examine agreement of GROC ratings between the patient (GROCp) and the treating therapist (GROCt), the impact on the minimal clinically important difference (MCID) estimates by reporting resources, and the relationships between the subjective GROC scores and objective outcome measures. : Data from 52,767 patients with orthopedic lumbar spine impairments treated in 623 outpatient rehabilitation clinics in 34 states (United States) were analyzed. Patient's functional status (FS) before and after the treatment was measured using the Lumbar Computerized Adaptive Testing (LCAT) survey (0-100 scale). The GROC ratings were obtained from both the patients and their caring therapists at discharge. : On average, GROCp (mean [(SD] = 3.1 [4.1]) was 1.9 points lower than GROCt (mean [SD] = 5.0 [1.9]). There were negligible differences between MCID estimates derived from the patients' GROC ratings (MCID cutoff = 9.2) and from the therapists' GROC ratings (MCID cutoff = 9.5). While only analyzing patient data whose GROCp ≥ 0, the intraclass correlation coefficient between GROCp and GROCt was 0.61, the GROCp correlated with FS at intake at = 0.12, with FS at discharge at = 0.56, and with FS change scores at = 0.47. : Therapists tended to report higher GROC ratings than their patients did but there were negligible differences between MCID estimates derived from GROCp and that derived from GROCt.
：总体变化评级（GROC）评分提供了一种衡量患者健康状况随时间自我感知变化的方法。：本研究的目的是检验患者（GROCp）和治疗师（GROCt）之间 GROC 评分的一致性、报告资源对最小临床重要差异（MCID）估计的影响，以及主观 GROC 评分与客观结局测量之间的关系。：分析了来自美国 34 个州的 623 家门诊康复诊所的 52767 名患有骨科腰椎疾病的患者的数据。患者治疗前后的功能状态（FS）使用腰椎计算机自适应测试（LCAT）调查（0-100 分）进行测量。GROC 评分在患者出院时同时从患者及其护理治疗师处获得。：平均而言，GROCp（平均值[标准差] = 3.1 [4.1]）比 GROCt（平均值[标准差] = 5.0 [1.9]）低 1.9 分。从患者的 GROC 评分（MCID 截止值 = 9.2）和治疗师的 GROC 评分（MCID 截止值 = 9.5）得出的 MCID 估计值之间几乎没有差异。仅分析 GROCp≥0 的患者数据时，GROCp 和 GROCt 之间的组内相关系数为 0.61，GROCp 与入院时的 FS 相关系数为 0.12，与出院时的 FS 相关系数为 0.56，与 FS 变化评分相关系数为 0.47。：治疗师倾向于报告更高的 GROC 评分，但从 GROCp 和 GROCt 得出的 MCID 估计值之间几乎没有差异。
